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1736A (10)
,.P., ,.�.. ..�,, .. .. . _�,.._.. O KERS COMPEN5ATIONDECLARATION �� /� �� �• s . -.. .� ._..- -- � u t� here6y aff m thot I hove a certfirate of 5on5eM to'self /�ppL��qT�Q� ._.��._ __ .Y ,._.. �*�"oY`arer�fedcopytheeof�Sec�38 0�ay�C���on Insurance, �6A667A . . C/'9p �O ���f� ""-. ...�._-_... _.__ ,_ -_. P �\✓IC L G PERM y F �"�dr t�.,.�i'Fa;.�l,a. .�,_:�wM „ � CE BV(REV,t0ib1} ..... , .�... . ,.. � IT_.. .� i Polic t � :,... . . . . _ �, . .� . .�� � ��S�'- 71�R�A ompany T'+ratnnn r T • n1 t COUPITY OF LOS ANGEtES �� �.;:� �� CerF�Yi+e�d copy.s he eby f�m sned � ` y -� � � Cert fied ropy is f led th the N � ��B �" .,�fiC'{ fon depa tment �oonty bui ing inspec-;� . �PORAPp��CANT,TOFlL M(PRIN70RTYoE�� �L BUILOMG � ILDING q D SqFEiY ��' �P .� 5t�..' .�.m�°�..a'c,��l.a. rE'���^...... � NUMBER � . . . «�.......... bote��,�R S I. �J � / FIXiURE OR ITEM @ FEE ", AODRESS����/ / � - �,:. ,„.; , ..:-.:: ���r�4��., } APP�Sani ,.. . . WATER CLOSEi � LOCAIITY � .. _ ._ . ,_...... k�.�'tCt�RTIFiCA7E:OF EXEMP71pN FROM WpRKERS' � �` �rt� � �' - ��/ Diamond Bar � � � �:.rry,t�, ��?"COMPE(V5ATION INSURANCE� � � - � �iH7Us - ` - NEAREST�' - � (ih�s secbon need not be complefed if the work involved by � .:�.,:.,: � ' .� cRoss sr. 6 D/Phi 11 ip sHowea s Ran �fhe permn is for one hundred dollars(SI00)or less.) OWNER' Ch A::� "�� �,�r Ihaf in the '- '.`c"" S011tl7. CiOl1T1'CY' � I ce I{y perfarmance�o{the work for which this - ✓aVqiORY � ���.� � �„r (� r�"i� s ssued I shall not em lo an .. J � MAIL. � - .� . �so os to become su6 ect to fhe W Y y Person n any mo er � SINK � � � ... ..��.::� � � ADORE55 ��,.��,.,y�$� .s�aaa,�,���� . o kers Compensat on La s � ��- . , . . . ��.��,-.� hr"'n.:-.r-„i.&ak4a'�' ?.� .::.....,,;. ..._ .... '� �( CITY� Cl f .�. �IJate . f DISHWASHER � .. .'. ----c----_APPI canf . .. ., .:. .. ..,, � � t,� �TfCE YO�.APPLICANT:��If, after� 9 .:......�.4. .. . -�"�. CONTRAC70R � • ...... - � ��'�'� CLOTHESWpSHER � � " R,C.�R �3`�„'�m TEt NO �+ n t an -' mok n �his Cert ficate of � � P you should bemme sub ect �o ihe -����"� '--" �� Tr�"sa�n r � Y . .Wokes' SWlMMINGPpOL'RLCEPTOR A�DR�� 1'Z785 �[a i. p ov�s'ons.�of the Lo6o Code, ou must forth- x�iih comply with such prov sions b tRis perm i shall be �� ������ n'O1� � zn , INc. z� deemed evoked . �AWNSPRINKCERSYSTEM � C,rY a Ave. �''������NSED CQNTRACiORS DECLARATION f WA7ER� � .! ..,HEATER �F R'v r ' rvo STATE p �/' p TEL �f he eby qff�m ihof I om I censed under p ovrsions of Chpp}er 9 � GAS SVSTEM L'�- ��CENSE NO. 3.]6y 2 p �IC � �,�,,�(commenc ng w ih Sectiott 700p)of Drv s on 3 of the B�siness�- � � and P ofe�ss ons Code and m I STRICT NO. �.��- ��,� .,n y y cense s in ful�fo ce and effect. � OUTtEiSOVFR ���� � �' �� �E� g36 � PINAL ...... CtAS n -- a ouners ,...._. ���;��s�� ... ae a .:SP � w.sr,x.,,�.,. ,. . ...- � 5 PER SYS7EM Y� �'tense Nombe�.�l� � ",-r^3-,�,:,s�wdMx�tk;� �4,_,., "��----Lic Class� � "^' .., .. �.,.,.�... , . 9- � con,a�,o R� Plumbin 6/19/85 . < oare j�•�ij/�-- VAL_ I�i�pN F- � Date—,�—_...._.__�:�. ,....�. . FINAL ; ' I om ezempf under Sec � �� _:� ,��F�, �..... . BY l.��i� L� ���s� w:��s:x�i`r.�a >., .. . . .��; . .., . .,.,:. , �P t for th s reoson � �� -��---- �'�+: ��.��^#p.w. � .. "� � , ��� r����J�s���� �����.m ;..� . ,. y � � � � � �,^w'; ���z.�..�'�..�.�.:�:��::�. ., , ooie______--- Plan check fee .� y�t"'N Signof re . . ' �.4 d' � �yy j.t��*��,§� �„��y,� � �J�� �� .. PLUM8ING PERMIT ISSUING FEE$� � � *��I� ""�"'�� �"��r� +� ��`��4������ ��'� "' rora�FEe... ��� �� � C ���4 .��.w�,"�,�:���*�SIIV�G'�L'E FAMILY3X.? ��''+�.�,�.f ��- . . � _ ,.,: s.. C�/ •� `"",'. ,`." Plaficheckapplimnt � � >'� � "+ H�ME pWNER-BUILDER DECLARq710N �`�� ' �'y�6� � ��`' �"'eby�otfirm�thot I om exempt from the � N°me G'' �I . . , . 0:� m e c 5 � � Controctor's Litense • � � � C. �� ° for ihe.following reaspn(Section 7031.5, Business ond� Address ��Pro{ess ons Code): -� � e . � � ,��� � �. ❑ „_�.. ..; ,..y. .;� � . . � Y �- ��,..- ,.�: � ,y � as owner of the properfy,will do the work ond rhe Te�_N . '- n -7,5 r�� ;��k �' ���-sh�cture."is nof i�niended or offered for sole�"(Sec}ion ��J��" . ._ :*`"y, r�.��7044 Bus.ness and P ofessians Code) � - ��� �� ��� ' -� - � � '� ,.�� a� .,�r�,,.; ,.. ...__ .: .,. .> -, •, i' -c�i J ,..�, . .:.�� ��,,o �`� ;'x�'CON�iRUC710N�LENDING AGENCY �� - � tl hereby offirm�ho}ihere s a const ucf on lending oye��y{o� � �� fhe performonce of the work for which ihis permi�is iss�ed : �(Sec,3097 C C) . ;'. t�u,'���t_....�::.a,. f'tir�.-:�s""�'�.�w,...<.»t-s�nx.,.��-,".` ,:.;>s ro�u�' ...::� � 4��.�;. ,b ,-•.S�3s: �.5��a'�,..:c..�,f.'t;� ... ..::s.�:.5. . �..r°r+ �-. ., .„ .r..., . a.�+r.�. .W a�s.'-.w,. .. ; Le de s Nome .. .+ ... ..-.: � 't��"� �r�'kti�tR.n a*7�z;A��'�,.�...�ch�i°�.��..._,. . ..n.', . ,. :' . a.._.�....H . ... , x. ., . .. .. Lender's q�dress � � � � � � � � �� �`. 1 ce tfy that I have�read ihis opplimtion and stote�lhat the.^�.::: .•u�..•.�'4}I.•�.�.,:�:T,� « ,,.:,..�, ��..«.�,i:�..„ -.�n:.. ,.�v. ....a•,. �*.. ..�..s, ,._..,..,�,.M ,..... . ,. ,.,.� . �w..-.................. ..<�' ..:.�� _ .,:�. � :_� . � a6ove ment o ed 5 c ,feC1 a9 ee to com I ���. �»"'� obove fo mato �'�� orc�nances and S�ote low;„regulce�ng�PI�,,mbiny lra d hereb� � � k 2iulho ze epresenldf es� f fh � - Y k o s C n '"yk,a ,n.,�} . P o erty{or ns ec on t�enier upon fhe u 'e�i z���' �2 �'e�a rP Purposes. . � . - - . . .. � . . ;c� � C R $ � � I�J $EE REVERSE FOR EXPlANATOkY IANGUAG� _ , , , �r'f,,.S9�atueofPermtte . ��1�9/RS . � .. . . . .., �. -' -�--�---•-�--r. � : a �,rr�� t. .:,i x :�, Da�e �. . .., :, . ,:: -: r t y; , � �.yrX^;.� J '�, r�+' N� .� . i�`ai.n e.�,�xa '����: a t r�+ e ��x', � �t.�. :�" +�.�.." � ::,. ... ... ,. . ... , ^- .....�...e,s..„.,,,,t;.n„ �.,_!�._.....,,�..^-�.��.�.." . . . . ...� .... � . .�.;��.. , ' �- ' •� �`'",�,w .������ � >� . �+�+ ,+^�`� +uwsro�tt2� ik : c-*rv�. x«-x�w rd�' +w9 G„' - w.n w .a ��ss��: � 3'�:4 r �,�. :�� ��#"��'�`�,�,"�'"�� � � � ,�,�-�r �.��.�f's� xse�a�a�wzca��s��,+v,�'t a"�s�� :� .. , s _ .Y . .. . ^�'�da.h�i"�akK�.r.., . ..,,,� .,": `;. ,,... � .,c' ,r :", _ .<� :a.: , .' .�..; _ .. �p°R'�CLARAi10N . . _ ',9. . :..;r ' . .� � . . ... ��.. -.. ._.., '� � ' pN+NERBJi .- ,�F � ,�" �� .. .�.. , -� . INSPECTOR'S NOTES . .. .. .�. � .. . .. ...ihe Cc�t c�o%s ��� �� ATE � INSPEC�'OR'S�SIGNATURE ---�-� � � . . � � � . he��aby oif m h8i oM'exeh'peosc !Sect on 7031.5. �� APPROVALS � ` �cense,Law 'for the rcllowing UNDER S4AB+V�IORK � � f� � ._� .. .._. . .- Business nnd Professmns Ccde,��^i'°m rove,dc�ncus��. RC�GH PLi7MBING� ��-� �Yd �,p+Ab� requires a permlf to corstrf°or�t'o�ifs issuance, clso re- GAS PIFING � � ���f f�O°' .�° . ... .. . . . .. ..�or repeir any strucfure, p4 'la a s� nad s±ate- _ ,_ .quires the ap����o^t�for suo•permid to.`, g � . ��',.� .::: ...-. � GAS VENt�� �' � �� :, .. . . .:. .. .. �..�.:. - .. :.. �-�'�:. . .� .' �. � � ment thvP ne is licensed pursuoni io`ha provis�ors o'hha HOT WATER�HEATER � „ .,._. , � Contrector's Lice�sc Caw(Cbapter 9(commer,any�i"' � . .. . .... ... __-----. ..... .�- .{... . .. .�� � . .��. Setfion 7000}of Division 3 of the 9usiness and Profes.. o�UPABiNG�FI�tURES -- '� � ���� - . � • s Code o fh t ha i�exem t t refrom o d 7 bosls . ' �a �$s- � f,�f-� — . sion ) � � p he n he � ��..t "� - . for�the alleged exemptlon. Any violation ol Sect'ror, � GAS iEST � , _ ._. .. . .. ....-. :.�:. -��", ... . ... .... . �, .- .,... UTILIiY�CO.N071FIED� _ ,._ .. .. . . � �-- .----;'— . . 7D31.5 by any opplicant for a permif subjecfs'ii�e opplr ..... .� ` �, �:.� --.------ ....�� ... �.. .' ...,, ..�. ' .."cont�to�a-civi!per.olty of not mare Fhan five hundred � .� �_.. .. _... - .. : . . .- .. . � � —T'� doilars(5500).: o� na � FINAL � �nter on �ronl . .., ._ � [],,as owner of,ihe property will do ih3�N k;.a � _ .. . :. ..:..-. :�,.::.,:._ ., . ..� . . .�. . .., . ��.-. . . . . . .. . -. ,_. .. , .. � . . ... ' .... ... .__ .. � .___ .��.. . .. ..., ..:.. .:,. �--- ._. .. . .. � . � !he struc7ure is not intended or o`fere o sc e _- c ., . ,s.:..... ..... . ...:.. .,_.. ..:.� �. , .:.. .($ec.7094,B�siness und Pro`essions Code The C• . �� tNDUSTRIA?".., , ..._.. . . .. .. . ..: _ .. , : NlA57F�APPROVAL tois Lfcense Law does rtot apP�Y to°^owner of pr"rsuch . . ... . . . . "; . .. . �� .. . - -:.. ,.-.. � �. . who boilds or improves�therean, and who does � � �.�v+o�k himself provided thaf such improvemenfs are not - - ,; ,.. �. ..:�: -.. � , :;��:` •��, "�' ,, ,��. �-��, ��' .. �� . �' _ - intended or oflered for sale.!f,however;the building or .`�. -. �. . '�� .-... _;., � ' �,.I� . . �... . ,.��; ' ... .. ..}. .sofd wi hin ono ye6r f com leficn,tbc . ".. �� ' -`_------ 'imp�ovemen is � ':• ::' :.. `�-. . ,... ''�.. .` . ' , � � . . . �. . owner-builder wtif h�ve'ths burden cf-proving tha`he did . ..� -. .,.: . . .�. � ' .�-<-. . ...... . ... . . .. e ar the purpose of sate.) . : �. . ... . . ..�� �;. . .. : .. � �' nb't�build or improP..;.. .. .: . ° �'_. . _'.. .. . • � - , � . � ' .,, .,,.�: .. ,..' . ..-::" .. . ..': . .'� �:: f�� � _ - . �--�--- . , . '.:.. ..:, .. . . . ..., . � . . �.. I�Qf1'1 BXB[17D4 Uf1C.�0Y�@C.� �: ,- , . ...:. ; . .. , �. ., . .�. ..":. .. ., � , �� .�.. :.. .�. ' .' .. _„ ` .' � . ' .�----- ..... .... ... � - ��'�. ' �'�� " �� B�&P.0 Yor this reason ,.. . . . . -:,<. � : �':.. �����..- :`.. . ..: ,..:. ' . ;...... . � te ._ • . . . .. . :::... ,. . .. _ , , �- . :.�, .. . �_ .: .: . .. ..�� � �D� � �� . �.� ...� . ` . :::. . ... , _ ".�--- .:. . . . . � , . . • � � �. . .�. � '.��� �:. a.. . .. � .. � � . �.-. . _ , .�.., .... _:... .�� . . _... Q�vner , ,- � .� . .�.� �-: -:r . : F ... , ,. . . . . .� � . ..:. .,. , .. . . .. _., .. . .� .: -.. �:..�� ... , . . :,. �,,:; .���� . ....�. . �.:': ..�'.K.,:" .. _.. �.... � ... �:.: . ' . .�. . .:. i-.,: . :-'.. : :.:.. � . . . . .. .. . .. . . , . ... '. ..� ....... . .,. . .�. .:.. .. ,. . a ...lNSPECTOR'S t�JOTES . _ . . . , . . _. , , ,;;::�{ _ „ � . . _,:. _ . .._ ..w:�, ..u. - _ ,, , ,., ,, . ...... _ .._. ,:. } .. .. - , , � _. ._ ,.„ . :_.-----------`- ,,. , , .. ::. ... -:.:_ . __:.. _ �: '__-=------'— ` " ;,. , ,. _ .. ---�:"